Recent advancements in detrended fluctuation analysis (DFA) allow evaluating multifractal coefficients scale-by-scale, a promising approach for assessing the complexity of biomedical signals. The multifractality degree is typically quantified by the singularity spectrum width (<i>W</i><sub>SS</sub>), a method that is critically unstable in multiscale applications. Thus, we aim to propose a robust multiscale index of multifractality, compare it with <i>W</i><sub>SS</sub> and illustrate its performance on real biosignals. The proposed index is the cumulative function of squared increments between consecutive DFA coefficients at each scale <i>n</i>: <i>α</i><sub>CF</sub>(<i>n</i>). We compared it with <i>W</i><sub>SS</sub> calculated scale-by-scale considering monofractal/monoscale, monofractal/multiscale, multifractal/monoscale and multifractal/multiscale random processes. The two indices provided qualitatively similar descriptions of multifractality, but <i>α</i><sub>CF</sub>(<i>n</i>) differentiated better the multifractal components from artefacts due to crossovers or detrending overfitting. Applied on 24 h heart rate recordings of 14 participants, the singularity spectrum failed to always satisfy the concavity requirement for providing meaningful <i>W</i><sub>SS</sub>, while <i>α</i><sub>CF</sub>(<i>n</i>) demonstrated a statistically significant heart rate multifractality at night in the scale ranges 16-100 and 256-680 s. Furthermore, <i>α</i><sub>CF</sub>(<i>n</i>) did not reject the hypothesis of monofractality at daytime, coherently with previous reports of lower nonlinearity and monoscale multifractality during the day. Thus, <i>α</i><sub>CF</sub>(<i>n</i>) appears a robust index of multiscale multifractality that is useful for quantifying complexity alterations of physiological series. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.
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